Reamer Breakage during Intramedullary Nailing in Tibial Shaft Fractures: A Case Report and Review of Literature
Abstract
Background: Interlocked intramedullary nailing is the most common treatment for closed tibial fractures. Reaming is a fundamental step in this surgical technique, and reamer breakage is a rare yet challenging complication during this operation.
Case Report: A 34-year old male with a tibial shaft fracture was admitted for early closed tibial nailing. During the reaming process, the reamer broke and stuck in the medulla at the isthmus level. We extracted the broken piece by back hammering a cannulated T-handle placed on the ball tip guide pin.
Conclusion: In this closed and quick method, we did not use any extra device other than standard equipment of intramedullary nailing.
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9. Boruah T, Kumar S, Patralekh MK, Prashad S, Chandra V, Debbarma I, et al. Removal of intra-operatively broken flexible reamer: An innovative use of jumbo cutter. J Clin Orthop Trauma. 2019;10(3):620-3. doi: 10.1016/j.jcot.2018.09.003. [PubMed: 31061601]. [PubMed Central: PMC6492215].
10. Abbassi N, Agoumi O, Kharaji A, Daoudi A, Najib A, Yacoubi H. How to manage a breaking reamer? Two case reports and literature review. J Orthop Trauma Surg Rel Res. 2017;12(3):46-8.
11. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA
statement. PLoS Med. 2009;6(7):e1000097. doi: 10.1371/journal.pmed.1000097. [PubMed: 19621072]. [PubMed Central: PMC2707599].
12. Jiang GQ, Zhang YD, Zhuang YQ. Removal of broken reamer stuck into femoral shaft in implanting PFNA: A case report. SICOT J. 2018;4:31. doi: 10.1051/sicotj/2018024. [PubMed: 30004864]. [PubMed Central: PMC6044857].
13. Low TH, Loke YH, Chiu CK. Minimally invasive retrieval of incarcerated flexible intramedullary reamer. Eur J Orthop Surg Traumatol. 2012;22(Suppl 1):113-5. doi: 10.1007/s00590-012-0995-y. [PubMed: 26662760].
14. Meena S, Trikha V, Singh V, Mittal S, Kishanpuria TS. Uncoiling of reamer during intramedullary nailing for fracture shaft of femur. J Nat Sci Biol Med. 2013;4(2):481-4. doi: 10.4103/0976-9668.116985. [PubMed: 24082759]. [PubMed Central: PMC3783807].
15. Kumar A, Jain A, Saurabh S, Trikha V, Mittal S. Technical tip for removal of broken cephalomedullary reamer tip in cases of proximal femoral nailing. J Clin Orthop Trauma. 2019;10(5):969-71. doi: 10.1016/j.jcot.2019.01.014. [PubMed: 31528077]. [PubMed Central: PMC6739251].
2. Puno RM, Teynor JT, Nagano J, Gustilo RB. Critical analysis of results of treatment of 201 tibial shaft fractures. Clin Orthop Relat Res. 1986;(212):113-21. [PubMed: 3769277].
3. Tornetta P, Ricci W, Court-Brown CM, McQueen MM. Rockwood and green's fractures in adults. Philadelphia, PA: Wolters Kluwer Health; 2019.
4. Gardner MJ, Nork SE, Barei DP, Kramer PA, Sangeorzan BJ, Benirschke SK. Secondary soft tissue compromise in tongue-type calcaneus fractures. J Orthop Trauma. 2008;22(7):439-45. doi: 10.1097/BOT.0b013e31817ace7e. [PubMed: 18670282].
5. Court-Brown CM, Christie J, McQueen MM. Closed intramedullary tibial nailing. Its use in closed and type I open fractures. J Bone Joint Surg Br. 1990;72(4):605-11. doi: 10.1302/0301-620X.72B4.2380211. [PubMed: 2380211].
6. Rijal L, Manandhar H, Nepal P, Ansari T, Yadhav CS. Instrument fails, but surgeon should not. Surgical techniques for retrieval of broken intramedullary reamer from tibia. Eur J Orthop Surg Traumatol. 2010;20:505-7. doi: 10.1007/s00590-010-0591-y.
7. Brewster NT, Ashcroft GP, Scotland TR. Extraction of broken intramedullary nails--an improvement in technique. Injury. 1995;26(4):286. doi: 10.1016/0020-1383(95)90020-x. [PubMed: 7649641].
8. Bisbinas I, Ho YM, Learmonth DJ. Reamer breakage in the femoral medulla during total knee arthroplasty: should reamers have a finite life? J Arthroplasty. 2004;19(4):501-3. doi: 10.1016/j.arth.2003.12.075. [PubMed: 15188112].
9. Boruah T, Kumar S, Patralekh MK, Prashad S, Chandra V, Debbarma I, et al. Removal of intra-operatively broken flexible reamer: An innovative use of jumbo cutter. J Clin Orthop Trauma. 2019;10(3):620-3. doi: 10.1016/j.jcot.2018.09.003. [PubMed: 31061601]. [PubMed Central: PMC6492215].
10. Abbassi N, Agoumi O, Kharaji A, Daoudi A, Najib A, Yacoubi H. How to manage a breaking reamer? Two case reports and literature review. J Orthop Trauma Surg Rel Res. 2017;12(3):46-8.
11. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA
statement. PLoS Med. 2009;6(7):e1000097. doi: 10.1371/journal.pmed.1000097. [PubMed: 19621072]. [PubMed Central: PMC2707599].
12. Jiang GQ, Zhang YD, Zhuang YQ. Removal of broken reamer stuck into femoral shaft in implanting PFNA: A case report. SICOT J. 2018;4:31. doi: 10.1051/sicotj/2018024. [PubMed: 30004864]. [PubMed Central: PMC6044857].
13. Low TH, Loke YH, Chiu CK. Minimally invasive retrieval of incarcerated flexible intramedullary reamer. Eur J Orthop Surg Traumatol. 2012;22(Suppl 1):113-5. doi: 10.1007/s00590-012-0995-y. [PubMed: 26662760].
14. Meena S, Trikha V, Singh V, Mittal S, Kishanpuria TS. Uncoiling of reamer during intramedullary nailing for fracture shaft of femur. J Nat Sci Biol Med. 2013;4(2):481-4. doi: 10.4103/0976-9668.116985. [PubMed: 24082759]. [PubMed Central: PMC3783807].
15. Kumar A, Jain A, Saurabh S, Trikha V, Mittal S. Technical tip for removal of broken cephalomedullary reamer tip in cases of proximal femoral nailing. J Clin Orthop Trauma. 2019;10(5):969-71. doi: 10.1016/j.jcot.2019.01.014. [PubMed: 31528077]. [PubMed Central: PMC6739251].
| Files | ||
| Issue | Vol 7, No 1 (2021) | |
| Section | Case Report | |
| DOI | https://doi.org/10.18502/jost.v7i1.5964 | |
| Keywords | ||
| Intramedullary Nailing; Orthopedic Fixation Devices; Tibial Fractures | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Kazemi M, Sharafi M, Shayan-Moghadam R. Reamer Breakage during Intramedullary Nailing in Tibial Shaft Fractures: A Case Report and Review of Literature. J Orthop Spine Trauma. 2021;7(1):27-30.
